Individual
SOPHIE MANIGO FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 CREEKVIEW CT, GREENVILLE, SC 29615-4800
(864) 609-4108
Mailing address
26 LEONE AVE, GREENVILLE, SC 29617-3932
(864) 551-5763
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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